Toggle Main Menu Toggle Search

Open Access padlockePrints

Microvascular disease: What does the UKPDS tell us about diabetic nephropathy?

Lookup NU author(s): Professor Rudy Bilous

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Abstract

The UK Prospective Diabetes Study is the largest study in Type 2 diabetes with pre-specified renal outcomes. The study showed that the natural history of nephropathy in newly diagnosed Type 2 diabetic patients was similar to that described previously in those with Type 1 diabetes. Around 2% per annum progress from normo- to micro-albuminuria [urinary albumin concentration (UAC) > 50 mg/l] and a further 2% from microalbuminuria to clinical grade proteinuria (UAC > 300 mg/l). Mortality rates for those with nephropathy are high, increasing from 1.4% per annum (normoalbuminuria) to 4.6% per annum (clinical grade proteinuria), and to 19.2% per annum for those with renal impairment. More intensive blood glucose control resulted in both a 33% reduction in relative risk of development of microalbuminuria or clinical grade proteinuria at 12 years, and a significant reduction in the proportion doubling their plasma creatinine (0.91 vs. 3.52%, P = 0.0028). Tighter blood pressure control also reduced microalbuminuria and clinical grade proteinuria; but at 6 years there was no effect on plasma creatinine levels. These data underline the importance of glycaemic and blood pressure control in Type 2 diabetes in order to prevent diabetic nephropathy. Those patients unlucky enough to develop nephropathy need intensive surveillance and correction of cardiovascular risk factors. © 2008 The Author.


Publication metadata

Author(s): Bilous R

Publication type: Article

Publication status: Published

Journal: Diabetic Medicine

Year: 2008

Volume: 25

Issue: s2

Pages: 25-29

ISSN (print): 0742-3071

ISSN (electronic): 1464-5491

Publisher: Wiley-Blackwell

URL: http://dx.doi.org/10.1111/j.1464-5491.2008.02496.x

DOI: 10.1111/j.1464-5491.2008.02496.x


Altmetrics

Altmetrics provided by Altmetric


Share